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HomeMy WebLinkAboutPermit Building 1994-9-9 RESIDENTIAL PERMIT APPLICATION Ins pect! ons:726-3769 Office: 726.3759 . SPRINGFIELD LOCATION OF PR0POSED WORK: ~ 2~1 ~SSESSORS MAP' t?{)~(}::\M LOT' c:::;- 0 .. Cci S L..?( ~ BLOCK: OWNER:3~ \~ '\\ e. '12\ LL. ADDRESS:' 525"' (2. ~.. ~ cc... ~ "3~ I ~ CITY: ....5~ <QQ~_ ~ i- STAT 1=. ()VE:.9 ClV\ DESCRIBE WORK: 'NEW Y REMODEL ~~. ~ l)tldoftrtL .- CONST. CONTRACTQR'S NAME., ' ADDRESS'. CONTRACTOR # -rlrJz( (( bto~5 ~L-S- /'.r:..stl/t.ci L/h20 I .PLUMBING: .tJ.LI4rfl)FGzs~ ?~6(. ~ ..J MECHANICAL: A:-Llk1A. F~ </L-A I'.o~ '10 I YU: J<rt.-.,:''d, ELECTRICAL: L'-Otv\ h. {/V\- ~c.. -f- GENERAl. t QUAD AREA: # OF BLDGS: L\R~~ ~. . \~~~ ~ '~ . {;? '--" OCCY GROUP: ...... -t..r# OF STORIES: " .. \ \VATER HEATER: ......./.,," J . rvl 'foundation - After forms are L.f)Verected but prlortoconcrete / placement. ,// D Underground Plumbing - Prior to filling trench. 1Vl. Underfloor Plumbing/Mechanical L....fW - Prior to Insulation or decking. rvl Post and Beam - Prior to floor L..f"J Insulation or decking, r\11 Floor Insulation - Prior to LfJ decking, r\7l Sanitary Sewer - Prior to filling L.f"J trench. f\7I Storm Sewer - Prior to filling ( trench. . , r\7l Water Line - Prior to filling" T trench. ". .' "rv::J ~R~ugh Pluinblng -:'::-Pi'lorto L-f>J cover. . ADDITION , DEMOLlS~ OTHER ;OB NUMBER 7,4/0 L;~ 225 Fi fth Street Springfield, Oregon 9 Si~ ~, C)V-C'-5' ~ TAX LOT:. . n~IIOU~1// SUBDIVISION: F:~+o-v\ PHONE: ~ ? Zr;. I 57 C/ ZIP: 97'f7 ~ EXPIRES c:; h 26 l { PHONE / l-k~ ~ ~c \ - OFFICE USE - L,AND USE: \ \ \; 1 \\{ & I CO NSTR. TYPE: IV , To re<htest an Inspection, you must call 726-3769. This Is a24 hour re'6ordlng. All Inspections requested before 7:00 a.m, will be made.tfi,~ same working day, Inspectlons requested after 7:00 a.m. will be made the fOllowing work day, ~ ~, \ REQUIRED INSPECTIONS . i',... 4J Temp~)ary Electric ~ ~~~e~~ Mechanical - Prior to ; .~\." m Site I'n~pectlon '- To be made . r'll RoughEle~trlcal ...,. Prl6r to ' Lpd after e>:cavatlon, but prior to '--f! cover. setllngiforms. . . 1 ... O UndersJlab Plumblng/Electrlcal/. . MechEmlcal. - Prior to cover. t .. rvJ Footl:hg - After trenches are L-f<J excavated; .' I ..,. ( " , m Ma;~onry - Steel ,location, bond ~ be,;ams, grouting. , # OF UNITS: HEAT SOURCE: S RANG E: . . f\7I Electrical Service -- Must be 7 approved to obtain permanent electrical power. rvl Fireplace - Prior to facing ~ materials and framing Insp, EfJ Framing - Prior to cover, m Wail/Ceiling Insulation - Prior to r cover.. . Lf1 Drywall - Prior to taping. o Wood Stove - After Installation. o Insert - After fireplace apprOVl!l1 and Installation of unit. r\1l Curbcut & Approach -'After ~ forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. o Fence. - When completed, CfJ ,Street Trees - When all req,ulred trees are planted: . I. . -. -, .-. . ...?" FLOOD PLAIN: ' 'tONING CODE: L-D.e...J #. OF BDRMS: ~ _ SECONDARY HEAT:t='t-J SQUARE FOO;AGE: s::fl35.. c:; , - r11 Final Plumbing - When all TPI~mblng w()rk Is complete, rYl Final Electrical .,- When all '{ electrical work Is complete. f'llFlnal Mechanical ~ When all T mechanical work Is complete, rvJ Final Building - When all ~ required Inspections have been approved and building is . completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set-Up - When all . blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When . blocking, set-up. and plumbing Inspections have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Install~9. "";" Lot faces tJ Lot sq. ftg. Lot coverage Topography Total height ~ (" r=-.rr ) I.. BUILDING PERMIT sa. FT. ITEM Main /779 ~?&, Garage Carport Total Value Building Permit Fee State Surcharge Total Fee PLUMBING PERMIT ITEM Lot Typ\ X Interior 'I('f.'\! .. '(' "i J., .,~'j:~~.,,: 'i'ii '~r' . ":' ') I' :i}:"j~t,~, Setbacks ' HSE GAR ACe' ~ .~ ' ;'~~' :,;r'::, ;l .,j., Corner h~L. , " .1. N Is \W IE /O~/tl- i..\ ~s. ~I ?~p~ed By: ~~~~ lj:~ ~\~ (A) 'i)()..CI1. PI~~ Reviewed By SYSTEMS DEVELOPMENT CHARGE (SDC) 12 -1~1. ';-/ Panhandle -* Cul-de-sac X $/so. FT, Si6, '<,0 VALUE '1 '7 <j 8"'J " ~ /2/ (B) FEE Fixtures Residential Bath(s) NO 3 Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan l ~~, C:~ ~~ ~~.,w.1J\ (C) t ~~, S.s;? c ,,~ \.. (% f;. c!fI '--olf. Dryer Vent Wood Stove/Insert/ Fireplace Unit NO '-t ~,~ loot ~ l~.~ \ S. Cr\) 3. qJ,a"" Mechanical Permit Issuance State Surcharge Total Permit ~ ~ ~w.t",- (D) "to.CO \O.su.. .9...~ \,~ C" "? 1~ .... 1, 'r.~ ~ MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk J.tS :\~ II ft Curbcut Demolition State Surcharge Total Miscellaneous Permits 1 ~,1S.. l~.~ ~l.~ (E) ~,':I~' TOTAL AMOUNT DUE (excluding electrjmtTl~~ (A, B, C, D, and E Combined) 32tG~,?1 I IS THEPROPOSED WORK.tN THE_ HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the City. of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: 29~ <:;; / ,'YJ~/9,~ /<~7J ~~- -'f"'" " v- ~ Date Paid: Receipt Number' ~:~~ Systems Development Charge is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS ~+- T: t~1000 , ~\\MlL-Dn,to )', ,//~ :L ~11J\ ^~rt Q_.J ~-K~Ct ~~~.t;, U~~~\A.t I u~~t- ,- ~" \) J ! By signature, I state and agree, that I have care,'ully examined the completed application and do hereby cl~rtlfy that all Informatlon hereon is true and correct, and I flJrther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, an d the Laws of the State of Oregon pertaining to the work Ijescrlbed herein, and that NO OCCUPANCY will be mad.~ of any structure without permission of the Building Safety Division, \ I further certify that only contractors and employees\ who are In compliance with ORS 701.055 will be used on tf\'J~ project. '" I further agree to ensure that all required Inspections are requested at the proper time, that each address Is readable from the street, that the permit card Is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. SI~ure Date VALIDATION: RECEIPT NUMBER /~& G DATE PAID '7(9'/5'~ ~ ' - Q;;) Po- 3 7't AMOUNT RECEIVED . ~"'-,;---_._~ c 0C,2, ~./f 4/-/( ~ -VI \ RECEIVED BY / .H NO. L4/tJ U CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) ATIACHMENT B1 NAME OR COMPANY: LOCATION: ,),;..1 DEVELOPMENT TYPE: BUILDING SIZE: 1. STORM ORATNAl1E IMPERVIOUS SQ. FT. I2rA \[~~ /. .... . ~ ?-/. Cj~/ I~OT SIZE SQ. Ft. 23"3/ X $0.209. PER SQ'. FT. $ S'l/, t; 8"" 2. ~ANITARY SFWFR-CITY NO. OF PFU'S 2.3. (See Reverse) 3. TRANSPORTATION X $43.26 PER PFU $ q r 4. f 7 NO OF UNITS, X TRIP RATE X COST PER TRIP / X j,cJ/ 'X $436.19 x X X $436.19 X $436.19 $' 4.f(),SS- $ $ SUBTOTAL (ADD' ITEMS 1.2. & 3} $ ~o2 r.2-/ 4. SANTTARY SEWFR-MW~ . NO. OF PFU'S 23 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 46S".3 r (Use PFU Total From Item 2 Pbove) -' '...~ $ 'sl. 70 $ J S-:S. ~ .,. MWMC CREDIT IF APPLICABLE (SEE REVERSE) ... ' ,...IQIM -MWMr. SOC:. SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 23 80. ~ ~ 5. ~~I~.ISIATTVF FFES ~ . . - ... BASE-CHARGE (SUBTOTAL ABOVE) X .05 -it: /,J) ; '::"~~t~:';-;;~r~ / Mar~ ~ornig. P. r. ) SD( COordinator V $ //r:()3 . _. . I.. _ ~i. . . . . TOTAl SQC $:z.f'l?l/ B2 . SDC . . . . ... ..... . .:,,',,", .... ~, -- ~'-..... FIXTURE UNrf CALCULtV.1t>N TABLE: Number'of New FixtureS X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate pnly the MEI additional fixtures) NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIV ALENT UNITS '-., I 2 1 2 3 6 2 6 6 1 3 2 l1Head 2 2 , 6 4 j-. 4- Bathtub. .'....................... ........... .................................... Drinking Fountain...... ........ ....................................... Floor Drain.............................. ......... ...... ................... Interceptors For Grease/Oil/Solids/Etc.......:.......... Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Clotheswasher.............. .............. .~..... Clotheswasner - ~_ Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall...................... ............. .............. Shower, Gang................... ............:.......................... Sink: Bar, Commercial, Residential Kitchen........................ Urinal, Stall/Wall..:.................................................... Wash Basin/Lavatory, Single........................ .......... Toilet, Public Installation........................................ Toilet, Private....................................................... Miscellaneous: 2.. :t.. z. 3 ~ ? 1:2. ..-, , TOTAL FIXTURE UNITS = 2-~ CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, caiculate credits separ'ates. Year Annexed Rate per $1,000 Assessed Value Year, Annexed. Rate per $1 ,000 Assessed Value 1979 or before 1980 1981 1982 1983 ',1984 ' 1985 $3.46 3.38 3.32 3.21 3.06 2.92 2.73 1985 1986 1987 1988 1989 1990 1991 1993 $2.46 , 2.14 1.77 1.37 0.97 0.61 0.44 0.15 " Improvement (if after annexation date) " ;I( ,. '. J,46 X $. /5: OVD (Rate X Assessed Value) X $ (Rate X Assessed Value) = .5"/, ?o Credit: for 'Parcel or land Only If Applicable = ------ CREDIT TOTAL = $ S-/, 90 ;* UNKh'oWN ANNe-A'DATf ,) Bu I,.A ).oT Or T#IS 4~eA WAs. ,Ptflo,e TO 1'1'11. . - -0. ,t._. f\' ~e YY}ll~!!!~!~!!~ OA\fV1t. Job No. .=:nu,. \ SYSTEMS DEVELOPMENT CHARGE "' WORKSHEET NAME:~ct". \\)\\o\L .. ADDRFSS\J \~ S ~I\D~ftL LOCATION OF IllROPOSED BUIL~R S9\E: f\...." P\\ 0... ,J " Street Address if Known: \ Y')~ ~ -\ .( ID1WJL...; = TaxLotNumber: \~~ (_) \\(X) . PHONE: 1 ~ \:)Ct- STATE: ~IP ~ PlattNaml~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back,) A. Single Family - Detached l Single Family home NO OF UNITS l B. Sinl!le Family - Attached NO OF UNITS C. Multi-Family Aoartment NOOF UNITS D. Manufactured Home Park NO OF UNITS Manufactured home not in a park $ 4\)).LD X $400 PER UNIT .5=. X $370 PER UNIT = -$ X $277 PER UNIT = $ X $280 PER UNIT = $ WPRD SDC $ {t~~ $ff $ 4DD.oU 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approyal. See SOC Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl c~~~J) City of Springfiel~~i r/5' Date /;Y